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Senate Bill 2216

Senate Bill sb2216c1

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    Florida Senate - 2004                           CS for SB 2216

    By the Committee on Health, Aging, and Long-Term Care; and
    Senator Jones




    317-2293-04

  1                      A bill to be entitled

  2         An act relating to public health care; amending

  3         s. 381.0012, F.S.; expanding the environmental

  4         health enforcement authority of the Department

  5         of Health; authorizing the department to issue

  6         citations or order payment of fines; providing

  7         requirements and limitations; providing a

  8         criminal penalty; providing for deposit and use

  9         of fines; amending s. 381.004, F.S.; providing

10         additional criteria for release of HIV

11         preliminary test results; amending s. 381.0065,

12         F.S.; modifying standards for rulemaking

13         applicable to regulation of onsite sewage

14         treatment and disposal systems; revising

15         research award qualifications; providing for an

16         extended right of entry; amending s. 381.0101,

17         F.S.; revising definitions; revising

18         environmental health professional certification

19         requirements; clarifying exemptions; creating

20         s. 381.104, F.S.; creating an employee health

21         and wellness program; providing requirements;

22         authorizing state agencies to undertake certain

23         activities relating to agency resources for

24         program purposes; requiring each participating

25         agency to make an annual report; providing

26         duties of the department; amending s. 384.25,

27         F.S.; revising reporting requirements for

28         sexually transmissible diseases; authorizing

29         the department to adopt rules; amending s.

30         384.31, F.S.; revising sexually transmissible

31         disease testing requirements for pregnant

                                  1

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    Florida Senate - 2004                           CS for SB 2216
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 1         women; providing notice requirements; creating

 2         s. 385.104, F.S.; establishing the Health

 3         Promotion and Health Education Statewide

 4         Initiative for certain purposes; providing

 5         requirements; authorizing the department to

 6         award funding to county health departments for

 7         certain purposes; providing funding

 8         requirements; providing participation

 9         requirements for county health departments;

10         amending s. 945.601, F.S.; revising a

11         cross-reference, to conform; creating s.

12         945.6038, F.S.; authorizing the State of

13         Florida Correctional Medical Authority to enter

14         into agreements with other state agencies to

15         provide additional medical services; providing

16         a limitation; providing an effective date.

17  

18  Be It Enacted by the Legislature of the State of Florida:

19  

20         Section 1.  Subsections (6) and (7) are added to

21  section 381.0012, Florida Statutes, to read:

22         381.0012  Enforcement authority.--

23         (6)  When a violation of s. 386.01, s. 386.041, or

24  environmental health rules adopted under this chapter occurs,

25  and such violation is enforceable by administrative or civil

26  remedy or is a second-degree misdemeanor, the department may

27  issue a citation that contains an order of correction, an

28  order to pay a fine, or both. A citation issued under this

29  subsection constitutes a notice of proposed agency action.

30         (a)  Citations must be in writing and must describe the

31  particular nature of the violation, including specific

                                  2

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    Florida Senate - 2004                           CS for SB 2216
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 1  reference to the provision of statute or rule allegedly

 2  violated.

 3         (b)  The fines imposed may not exceed $500 for each

 4  violation. Each day constitutes a separate violation for which

 5  a citation may be issued.

 6         (c)  The citing official shall inform the recipient, by

 7  written notice pursuant to ss. 120.569 and 120.57, of the

 8  right to an administrative hearing. The citation must contain

 9  a conspicuous statement that failure to pay the fine within

10  the allotted time, or failure to appear to contest the

11  citation after having requested a hearing, constitutes a

12  waiver of the right to contest the citation.

13         (d)  The department may reduce or waive the fine

14  imposed by the citation after giving due consideration to such

15  factors as the gravity of the violation, the good faith of the

16  person who has allegedly committed the violation, and the

17  person's history of previous violations, including violations

18  for which enforcement actions were taken under this section or

19  other provisions of law.

20         (e)  Any person who willfully refuses to sign and

21  accept a citation issued by the department commits a

22  misdemeanor of the second degree, punishable as provided in s.

23  775.082 or s. 775.083.

24         (f)  The department shall deposit all fines collected

25  under the authority of this subsection in the County Health

26  Department Trust Fund for use in the environmental health

27  program under which the fine was issued and shall use such

28  fines to improve the respective programs or to provide

29  training to the regulated industry and department staff

30  working in such programs.

31  

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    Florida Senate - 2004                           CS for SB 2216
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 1         (g)  The provisions of this subsection are an

 2  alternative means of enforcing environmental health

 3  requirements which does not prohibit the department from using

 4  other means of enforcement. However, the department shall use

 5  only one method of enforcement for a single violation.

 6         (7)  The department may use positive means of

 7  enforcement to ensure compliance with environmental health

 8  requirements specified in this chapter, ss. 386.01 and

 9  386.041, or environmental health rules adopted under the

10  authority of this chapter. Such means of enforcement may

11  include requiring attendance at training courses applicable to

12  the violations committed and requiring the use of best

13  management practices currently used or recognized by the

14  appropriate regulated industry or governmental agency.

15         Section 2.  Paragraph (d) of subsection (3) of section

16  381.004, Florida Statutes, is amended to read:

17         381.004  HIV testing.--

18         (3)  HUMAN IMMUNODEFICIENCY VIRUS TESTING; INFORMED

19  CONSENT; RESULTS; COUNSELING; CONFIDENTIALITY.--

20         (d)  No test result shall be determined as positive,

21  and no positive test result shall be revealed to any person,

22  without corroborating or confirmatory tests being conducted

23  except in the following situations:

24         1.  Preliminary test results may be released to

25  licensed physicians or the medical or nonmedical personnel

26  subject to the significant exposure for purposes of

27  subparagraphs (h)10., 11., and 12.

28         2.  Preliminary test results may be released to health

29  care providers and to the person tested when decisions about

30  medical care or treatment of, or recommendation to, the person

31  tested and, in the case of an intrapartum or postpartum woman,

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    Florida Senate - 2004                           CS for SB 2216
    317-2293-04




 1  when care, treatment, or recommendations regarding her

 2  newborn, cannot await the results of confirmatory testing.

 3  Positive preliminary HIV test results shall not be

 4  characterized to the patient as a diagnosis of HIV infection.

 5  Justification for the use of preliminary test results must be

 6  documented in the medical record by the health care provider

 7  who ordered the test. This subparagraph does not authorize the

 8  release of preliminary test results for the purpose of routine

 9  identification of HIV-infected individuals or when HIV testing

10  is incidental to the preliminary diagnosis or care of a

11  patient. Corroborating or confirmatory testing must be

12  conducted as followup to a positive preliminary test. Results

13  shall be communicated to the patient according to statute

14  regardless of the outcome. Except as provided in this section,

15  test results are confidential and exempt from the provisions

16  of s. 119.07(1).

17         3.  Positive rapid test results are considered

18  preliminary and may be released in accordance with the

19  manufacturer's instructions as approved by the United States

20  Food and Drug Administration. Positive rapid test results

21  require confirmatory testing for diagnosis and reporting of

22  HIV infection.

23         Section 3.  Paragraphs (a) and (j) of subsection (3) of

24  section 381.0065, Florida Statutes, are amended, and paragraph

25  (c) is added to subsection (5) of that section, to read:

26         381.0065  Onsite sewage treatment and disposal systems;

27  regulation.--

28         (3)  DUTIES AND POWERS OF THE DEPARTMENT OF

29  HEALTH.--The department shall:

30         (a)  Adopt rules to administer ss. 381.0065-381.0067,

31  including definitions that are consistent with the definitions

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    Florida Senate - 2004                           CS for SB 2216
    317-2293-04




 1  in this section, decreases to setback requirements where no

 2  health hazard exists, increases for the lot-flow allowance for

 3  performance-based systems, requirements for separation from

 4  water table elevation during the wettest season, requirements

 5  for the design and construction of any component part of an

 6  onsite sewage treatment and disposal system, application and

 7  permit requirements for persons who maintain an onsite sewage

 8  treatment and disposal system, requirements for maintenance

 9  and service agreements for aerobic treatment units and

10  performance-based treatment systems, and recommended

11  standards, including disclosure requirements, for voluntary

12  system inspections to be performed by individuals who are

13  authorized by law to perform such inspections and who shall

14  inform a person having ownership, control, or use of an onsite

15  sewage treatment and disposal system of the inspection

16  standards and of that person's authority to request an

17  inspection based on all or part of the standards, and

18  requirements for implementation of the United States

19  Environmental Protection Agency's voluntary national

20  guidelines for management of onsite and clustered or

21  decentralized wastewater treatment systems.

22         (j)  Supervise research on, demonstration of, and

23  training on the performance, environmental impact, and public

24  health impact of onsite sewage treatment and disposal systems

25  within this state. Research fees collected under s.

26  381.0066(2)(k) must be used to develop and fund hands-on

27  training centers designed to provide practical information

28  about onsite sewage treatment and disposal systems to septic

29  tank contractors, master septic tank contractors, contractors,

30  inspectors, engineers, and the public and must also be used to

31  fund research projects which focus on improvements of onsite

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    Florida Senate - 2004                           CS for SB 2216
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 1  sewage treatment and disposal systems, including use of

 2  performance-based standards and reduction of environmental

 3  impact. Research projects shall be initially approved by the

 4  technical advisory panel and shall be applicable to and

 5  reflect the soil conditions specific to Florida. Such projects

 6  shall be awarded through competitive negotiation, using the

 7  procedures provided in s. 287.055, to public or private

 8  entities that have experience in onsite sewage treatment and

 9  disposal systems in Florida and that are principally located

10  in Florida. Research projects shall not be awarded to firms or

11  entities that employ or are associated with persons who serve

12  on either the technical advisory panel or the research review

13  and advisory committee.

14         (5)  ENFORCEMENT; RIGHT OF ENTRY; CITATIONS.--

15         (c)  Department personnel may enter the premises of

16  others when necessary to conduct site evaluations and

17  inspections relating to the permitting of onsite sewage

18  treatment and disposal systems. Such entry does not constitute

19  trespass, and department personnel making such entry are not

20  subject to arrest or to a civil action by reason of such

21  entry. This paragraph does not authorize a department employee

22  to destroy, injure, damage, or move anything on the premises

23  of another without the written permission of the landowner.

24         Section 4.  Subsections (1), (2), (3), and (6) and

25  paragraph (a) of subsection (5) of section 381.0101, Florida

26  Statutes, are amended to read:

27         381.0101  Environmental health professionals.--

28         (1)  LEGISLATIVE INTENT.--Persons responsible for

29  providing technical and scientific evaluations of

30  environmental health and sanitary conditions in business

31  establishments and communities throughout the state may create

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    Florida Senate - 2004                           CS for SB 2216
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 1  a danger to the public health if they are not skilled or

 2  competent to perform such evaluations. The public relies on

 3  the judgment of environmental health professionals employed by

 4  both government agencies and private industries to assure them

 5  that environmental hazards are identified and removed before

 6  they endanger the health or safety of the public. The purpose

 7  of this section is to assure the public that persons

 8  specifically responsible for performing environmental health

 9  and sanitary evaluations have been certified by examination as

10  competent to perform such work.

11         (2)  DEFINITIONS.--As used in this section:

12         (a)  "Accredited" means recognized by the American

13  Council on Education as meeting acceptable levels of quality

14  and performance.

15         (b)(a)  "Board" means the Environmental Health

16  Professionals Advisory Board.

17         (c)(b)  "Department" means the Department of Health.

18         (d)(c)  "Environmental health" means that segment of

19  public health work which deals with the examination of those

20  factors in the human environment which may impact adversely on

21  the health status of an individual or the public.

22         (e)(d)  "Environmental health professional" means a

23  person who is employed or assigned the responsibility for

24  assessing the environmental health or sanitary conditions, as

25  defined by the department, within a building, on an

26  individual's property, or within the community at large, and

27  who has the knowledge, skills, and abilities to carry out

28  these tasks. Environmental health professionals may be either

29  field, supervisory, or administrative staff members.

30  

31  

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    Florida Senate - 2004                           CS for SB 2216
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 1         (f)(e)  "Certified" means a person who has displayed

 2  competency to perform evaluations of environmental or sanitary

 3  conditions through examination.

 4         (g)(f)  "Registered sanitarian," "R.S.," "Registered

 5  Environmental Health Specialist," or "R.E.H.S." means a person

 6  who has been certified by either the National Environmental

 7  Health Association or the Florida Environmental Health

 8  Association as knowledgeable in the environmental health

 9  profession.

10         (h)(g)  "Primary environmental health program" means

11  those programs determined by the department to be essential

12  for providing basic environmental and sanitary protection to

13  the public. These programs shall be established by rule and,

14  at a minimum, these programs shall include food protection

15  program work and onsite sewage treatment and disposal systems

16  program work system evaluations.

17         (3)  CERTIFICATION REQUIRED.--No person shall perform

18  environmental health or sanitary evaluations in any primary

19  program area of environmental health without being certified

20  by the department as competent to perform such evaluations.

21  The requirements of this section shall not be mandatory for

22  persons performing inspections of public or retail food

23  service establishments licensed under chapter 500 or chapter

24  509.

25         (5)  STANDARDS FOR CERTIFICATION.--The department shall

26  adopt rules that establish definitions of terms and minimum

27  standards of education, training, or experience for those

28  persons subject to this section. The rules must also address

29  the process for application, examination, issuance,

30  expiration, and renewal of certification and ethical standards

31  of practice for the profession.

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    Florida Senate - 2004                           CS for SB 2216
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 1         (a)  Persons employed as environmental health

 2  professionals shall exhibit a knowledge of rules and

 3  principles of environmental and public health law in Florida

 4  through examination. A person may not conduct environmental

 5  health evaluations in a primary program area unless he or she

 6  is currently certified in that program area or works under the

 7  direct supervision, during his or her initial probationary

 8  period for that position, of a certified environmental health

 9  professional.

10         1.  All persons who begin employment in a primary

11  environmental health program on or after September 21, 1994,

12  must be certified in that program within the initial

13  probationary period for that position 6 months after

14  employment.

15         2.  Persons employed in the primary environmental

16  health programs program of a food protection program or an

17  onsite sewage treatment and disposal systems system prior to

18  September 21, 1994, shall be considered certified while

19  employed in that position and shall be required to adhere to

20  any professional standards established by the department

21  pursuant to paragraph (b), complete any continuing education

22  requirements imposed under paragraph (d), and pay the

23  certificate renewal fee imposed under subsection (7).

24         3.  Persons employed in the primary environmental

25  health programs program of a food protection program or an

26  onsite sewage treatment and disposal systems system prior to

27  September 21, 1994, who change positions or program areas and

28  transfer into another primary environmental health program

29  area on or after September 21, 1994, must be certified by

30  examination in that program within 6 months after such

31  

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    Florida Senate - 2004                           CS for SB 2216
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 1  transfer, except that they will not be required to possess the

 2  college degree required under paragraph (e).

 3         4.  Registered sanitarians shall be considered

 4  certified and shall be required to adhere to any professional

 5  standards established by the department pursuant to paragraph

 6  (b).

 7         (6)  EXEMPTIONS.--A person who conducts primary

 8  environmental evaluation activities and maintains a current

 9  registration or certification from another state agency which

10  examined the person's knowledge of the primary program area

11  and requires comparable continuing education to maintain the

12  certificate shall not be required to be certified by this

13  section. Examples of persons not subject to certification are

14  physicians, registered dietitians, certified laboratory

15  personnel, and nurses.

16         Section 5.  Section 381.104, Florida Statutes, is

17  created to read:

18         381.104  Employee health and wellness program.--

19         (1)  Each state agency may allocate, from existing

20  resources, the necessary funding and facilities for the

21  development and maintenance of an employee health and wellness

22  program and may seek additional funding from other sources to

23  support the program for the benefit of the agency's employees.

24         (2)  Each state agency may dedicate resources to

25  develop and coordinate an employee health and wellness program

26  or arrange to cooperate with other agencies within such

27  agency's geographic proximity for program coordination,

28  including providers of state employee benefits.

29         (3)  Each state agency electing to participate shall

30  establish an employee health and wellness coordinator and

31  advisory committee to guide the development of an operational

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    Florida Senate - 2004                           CS for SB 2216
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 1  plan, including the collection of data and development of

 2  goals and objectives, and to oversee program evaluation and

 3  use of any agency-allocated funds.

 4         (4)  Each state agency may conduct and dedicate

 5  resources toward an employee needs assessment to ascertain the

 6  health-and-wellness-related needs of its employees.

 7         (5)  Each state agency may establish policies that

 8  allow employees no more than 30 minutes of work time three

 9  times each week, as individual workload allows, to use for the

10  purpose of engaging in health and wellness activities which

11  may include physical activity, stress reduction, tobacco

12  cessation, personal training, nutrition counseling, or weight

13  reduction and control. Such 30-minute periods may be used to

14  modify the start or end of the workday or to extend the lunch

15  hour.

16         (6)  Each state agency shall use an employee health and

17  wellness activity agreement form, developed by the Department

18  of Health, to be completed by the employee, signed by both the

19  employee and the employee's immediate supervisor, and kept in

20  the employee's personnel file prior to the employee's

21  participation in any activity. It is the responsibility of the

22  employee to complete the form and submit it to the personnel

23  office. Any change to the employee's activities requires

24  submission of a revised form. An employee found to be in

25  violation of the submitted agreement form is not allowed

26  further participation in the program.

27         (7)  Each state agency may designate up to 1 hour each

28  month for the purpose of providing inservice health and

29  wellness training for its employees.

30  

31  

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 1         (8)  Each state agency may use electronic mail and

 2  other communication systems to promote the agency's employee

 3  health and wellness activities.

 4         (9)  Each state agency may, and is encouraged to:

 5         (a)  Enter into an agreement or contract with other

 6  public or private entities to collaborate or participate

 7  jointly in health or wellness education or activity programs.

 8         (b)  Implement health education activities that focus

 9  on skill development and lifestyle behavior change along with

10  information dissemination and awareness building, preferably

11  tailored to the employees' interests and needs.

12         (c)  Review and offer recommendations to agency

13  leadership on environmental and social support policies that

14  pertain to improving the health of employees.

15         (d)  Link the employee health and wellness program to

16  other programs such as the employee assistance program and

17  other related programs to help employees balance work and

18  family.

19         (e)  Offer free, low-cost, or employee-fee-based

20  programs on site, including the designation of rooms for the

21  express purpose of physical activity, nutrition, stress

22  reduction, and weight control activities. Participating

23  agencies with established employee health and wellness

24  programs may purchase exercise equipment to be used in the

25  room designated for this purpose.

26         (10)  Each state agency that develops and implements an

27  employee health and wellness program shall include and

28  document an evaluation and improvement process in an annual

29  report to help enhance the program's efficiency and

30  effectiveness. The annual report shall be submitted to the

31  Department of Health on July 1 of each year. Agencies shall

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 1  use an annual report template provided by the Department of

 2  Health to ensure consistency in the presentation of data and

 3  other evaluation results.

 4         (11)  The Department of Health shall provide employee

 5  health and wellness model program guidelines and ongoing

 6  technical assistance to other state agencies to assist in the

 7  development of each agency's employee health and wellness

 8  program.

 9         Section 6.  Section 384.25, Florida Statutes, is

10  amended to read:

11         384.25  Reporting required.--

12         (1)  Each person who makes a diagnosis of or treats a

13  person with a sexually transmissible disease, including, but

14  not limited to, HIV and AIDS, and each laboratory that

15  performs a test for a sexually transmissible disease,

16  including, but not limited to, HIV, which concludes with a

17  positive result shall report such facts as may be required by

18  the department by rule, within a time period as specified by

19  rule of the department, but in no case to exceed 2 weeks.

20         (a)(2)  The department shall adopt rules specifying the

21  information required in and a maximum minimum time period for

22  reporting a sexually transmissible disease, including, but not

23  limited to, HIV and AIDS. In adopting such rules, the

24  department shall consider the need for information,

25  protections for the privacy and confidentiality of the

26  patient, and the practical ability of persons and laboratories

27  to report in a reasonable fashion. To ensure the

28  confidentiality of persons infected with HIV the human

29  immunodeficiency virus (HIV), reporting of HIV infection and

30  AIDS acquired immune deficiency syndrome (AIDS) must be

31  conducted using a system the HIV/AIDS Reporting System (HARS)

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 1  developed by the Centers for Disease Control and Prevention of

 2  the United States Public Health Service or an equivalent

 3  system.

 4         (3)  The department shall require reporting of

 5  physician diagnosed cases of AIDS based upon diagnostic

 6  criteria from the Centers for Disease Control and Prevention.

 7         (b)(4)  The department may require physician and

 8  laboratory reporting of HIV infection. However, only reports

 9  of HIV infection identified on or after the effective date of

10  the rule developed by the department pursuant to this

11  subsection shall be accepted. The Reporting may not affect or

12  relate to anonymous HIV testing programs conducted pursuant to

13  s. 381.004(4) or to university-based medical research

14  protocols as determined by the department.

15         (2)(5)  After notification of the test subject under

16  subsection (4), the department may, with the consent of the

17  test subject, notify school superintendents of students and

18  school personnel whose HIV tests are positive.

19         (3)  The department shall adopt rules requiring each

20  physician and laboratory to report any newborn or infant up to

21  18 months of age who has been exposed to HIV. The rules may

22  include the method and time period for reporting, information

23  to be included in the report, requirements for enforcement,

24  and followup activities by the department.

25         (4)(6)  The department shall by February 1 of each year

26  submit to the Legislature an annual report relating to all

27  information obtained pursuant to this section.

28         (5)(7)  Each person who violates the provisions of this

29  section or the rules adopted hereunder may be fined by the

30  department up to $500 for each offense. The department shall

31  report each violation of this section to the regulatory agency

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 1  responsible for licensing each health care professional and

 2  each laboratory to which these provisions apply.

 3         Section 7.  Section 384.31, Florida Statutes, is

 4  amended to read:

 5         384.31  Serological Testing of pregnant women; duty of

 6  the attendant.--

 7         (1)  Every person, including every physician licensed

 8  under chapter 458 or chapter 459 or midwife licensed under

 9  part I of chapter 464 or chapter 467, attending a pregnant

10  woman for conditions relating to pregnancy during the period

11  of gestation and delivery shall take or cause the woman to be

12  tested for sexually transmissible diseases, including, but not

13  limited to, HIV, as required by rule of the department,

14  notwithstanding s. 381.004(3)(a), taken a sample of venous

15  blood at a time or times specified by the department. The

16  tests Each sample of blood shall be performed tested by a

17  laboratory approved for such purposes under part I of chapter

18  483 for sexually transmissible diseases as required by rule of

19  the department. Pregnant women shall be notified of the tests

20  that will be conducted and of their right to refuse testing.

21  If a woman objects to testing, a written statement of

22  objection, signed by the patient, shall be placed in the

23  patient's medical record and no testing shall occur.

24         (2)  At the time the venous blood sample is taken,

25  testing for human immunodeficiency virus (HIV) infection shall

26  be offered to each pregnant woman. The prevailing professional

27  standard of care in this state requires each health care

28  provider and midwife who attends a pregnant woman to counsel

29  the woman to be tested for human immunodeficiency virus (HIV).

30  Counseling shall include a discussion of the availability of

31  treatment if the pregnant woman tests HIV positive. If a

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 1  pregnant woman objects to HIV testing, reasonable steps shall

 2  be taken to obtain a written statement of such objection,

 3  signed by the patient, which shall be placed in the patient's

 4  medical record. Every person, including every physician

 5  licensed under chapter 458 or chapter 459 or midwife licensed

 6  under part I of chapter 464 or chapter 467, who attends a

 7  pregnant woman who has been offered and objects to HIV testing

 8  shall be immune from liability arising out of or related to

 9  the contracting of HIV infection or acquired immune deficiency

10  syndrome (AIDS) by the child from the mother.

11         Section 8.  Section 385.104, Florida Statutes, is

12  created to read:

13         385.104  Health Promotion and Health Education

14  Statewide Initiative.--

15         (1)  The Department of Health shall establish the

16  Health Promotion and Health Education Statewide Initiative to

17  provide a comprehensive and community-based health promotion

18  and education program. The program is designed to provide

19  funding to counties in this state to improve individual and

20  community health, aimed specifically at preventing and

21  reducing the impact of chronic diseases and promoting healthy

22  lifestyles.

23         (2)  The program's targeted diseases include, but are

24  not limited to, diabetes, heart disease, stroke, asthma, and

25  cancer, with a focus on the preventable risk factors of

26  tobacco use, physical inactivity, and poor nutrition.

27         (3)  The implementation of these activities shall be

28  coordinated with and linked to existing state plans and

29  national priorities, focusing on evidence-based programs and

30  population-based efforts that specifically address social and

31  environmental policy strategies.

                                  17

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    Florida Senate - 2004                           CS for SB 2216
    317-2293-04




 1         (4)  Subject to the availability of funds, the

 2  Department of Health may award funding to county health

 3  departments for purposes of improving individual and community

 4  health by expanding and improving the health infrastructure

 5  through environmental and policy changes aimed specifically at

 6  preventing and reducing the impact of chronic diseases and

 7  promoting healthy lifestyles.

 8         (5)  To be eligible to receive funding under this

 9  section, a county health department shall submit an

10  application to the secretary of the Department of Health

11  containing information as required, including:

12         (a)  A description of the proposed activities and how

13  they promote tobacco cessation, healthy eating, or physical

14  fitness and address the health and social consequences to

15  residents of this state that have chronic diseases.

16         (b)  Information describing how health promotion and

17  education activities are to be coordinated at the local level

18  with other health activities conducted by other education,

19  health, and agricultural agencies.

20         (c)  Information describing how local health promotion

21  and education activities reflect state and national objectives

22  for health.

23         (d)  A description of the collaborative process that

24  the county health department employed in the development of

25  the health promotion and education program, including

26  consultations with individuals and organizations with

27  expertise in promoting public health, nutrition, or physical

28  activity.

29         (e)  A description of how the county health department

30  will evaluate the effectiveness of its program.

31  

                                  18

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    Florida Senate - 2004                           CS for SB 2216
    317-2293-04




 1         (6)  Subject to the availability of funds, a county

 2  health department receiving funds under this section shall,

 3  pending successful implementation or evaluation as determined

 4  by department headquarters staff, conduct the project for at

 5  least a period of 3 consecutive years.

 6         (7)  A county health department that receives funds

 7  under this section may use the funds to carry out one or more

 8  of the following activities:

 9         (a)  Collect, analyze, and disseminate data related to

10  diabetes, heart disease, stroke, asthma, and cancer, with a

11  focus on the preventable risk factors of tobacco use, physical

12  inactivity, and poor nutrition.

13         (b)  Develop and implement activities to create a

14  comprehensive, coordinated nutrition and physical fitness

15  awareness and chronic disease prevention program.

16         (c)  Develop and implement programs in schools and

17  worksites to increase physical fitness and to enhance the

18  nutritional status of residents of this state.

19         (d)  Develop and implement policy and environmental

20  changes related to the cessation of tobacco, healthful

21  nutrition, and physical education.

22         (e)  Collaborate with community-based organizations,

23  volunteer organizations, state medical associations, and

24  public health groups to develop and implement health education

25  and promotion activities.

26         (f)  Collaborate with public and private organizations

27  that have a mission to increase public awareness of the

28  importance of a balanced diet and an active lifestyle.

29         Section 9.  Section 945.601, Florida Statutes, is

30  amended to read:

31  

                                  19

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    Florida Senate - 2004                           CS for SB 2216
    317-2293-04




 1         945.601  Correctional Medical Authority; ss.

 2  945.601-945.6038; 945.601-945.6035, definitions.--As used in

 3  this act:

 4         (1)  "Authority" means the State of Florida

 5  Correctional Medical Authority created in this act.

 6         (2)  "Health care provider" means:

 7         (a)  A regional research hospital or research center

 8  which is authorized by law to provide hospital services in

 9  accordance with chapter 395, which has a contractual or

10  operating arrangement with a regional school of medicine, and

11  which is located at that regional school of medicine;

12         (b)  Any entity which has agreed to provide hospital

13  services to inmates in the Department of Corrections; or

14         (c)  Any entity licensed to provide hospital services

15  in accordance with chapter 395.

16         (3)  "Project" means any structure, facility,

17  machinery, equipment, or other property suitable for use by a

18  health facility in connection with its operations or proposed

19  operations, including, without limitation, real property

20  therefor; a clinic, computer facility, dining hall,

21  firefighting facility, fire prevention facility, long-term

22  care facility, hospital, interns' residence, laboratory,

23  laundry, maintenance facility, nurses' residence, office,

24  parking area, pharmacy, recreational facility, research

25  facility, storage facility, utility, or X-ray facility, or any

26  combination of the foregoing; and other structure or facility

27  related thereto or required or useful for health care

28  purposes, the conducting of research, or the operation of a

29  health facility, including a facility or structure essential

30  or convenient for the orderly conduct of the health facility

31  and other similar items necessary or convenient for the

                                  20

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    Florida Senate - 2004                           CS for SB 2216
    317-2293-04




 1  operation of a particular facility or structure in the manner

 2  for which its use is intended. "Project" does not include such

 3  items as fuel, supplies, or other items which are customarily

 4  deemed to result in a current operating charge.

 5         (4)  "Quality management program" means to monitor and

 6  evaluate inmate health care and includes the following

 7  objectives:

 8         (a)  Assuring that all inmates receive appropriate and

 9  timely services in a safe environment.

10         (b)  Assuring systematic monitoring of the treatment

11  environment.

12         (c)  Assisting in the reduction of professional and

13  general liability risks.

14         (d)  Enhancing efficient utilization of resources.

15         (e)  Assisting in credential review and privilege

16  delineation.

17         (f)  Enhancing the identification of continuing

18  educational needs.

19         (g)  Facilitating the identification of strengths,

20  weaknesses, and opportunities for improvement.

21         (h)  Facilitating the coordination and integration of

22  information systems.

23         (i)  Assuring the resolution of identified problems.

24         (5)  "Real property" includes all lands, including

25  buildings, structures, improvements, and fixtures thereon; any

26  property of any nature appurtenant thereto or used in

27  connection therewith; and every estate, interest, and right,

28  legal or equitable, therein, including any such interest for a

29  term of years.

30         Section 10.  Section 945.6038, Florida Statutes, is

31  created to read:

                                  21

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    Florida Senate - 2004                           CS for SB 2216
    317-2293-04




 1         945.6038  Additional services.--The authority is

 2  authorized to enter into an agreement or may contract with the

 3  Department of Children and Family Services, subject to the

 4  availability of funding, to conduct surveys of medical

 5  services and to provide medical quality assurance and

 6  improvement assistance at secure confinement and treatment

 7  facilities for persons confined under part V of chapter 394.

 8  The authority may enter into similar agreements with other

 9  state agencies, subject to the availability of funds. The

10  authority may not enter into any such agreement if doing so

11  would impair the authority's ability to fulfill its

12  obligations with regard to the Department of Corrections as

13  set forth in this chapter.

14         Section 11.  This act shall take effect upon becoming a

15  law.

16  

17          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
18                         Senate Bill 2216

19                                 

20  The Committee Substitute no longer grants authority to the
    Department of Health to adopt rules, issue permits, and assess
21  fees in its enforcement of environmental health in group care
    facilities. The requirement for the department to reactivate
22  the license of a retired medical physician to participate in
    clinical research is deleted.
23  

24  

25  

26  

27  

28  

29  

30  

31  

                                  22

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